| NPI | 1295273639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NHI DAI Physician Assistant Certified 702-927-3599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 54015) |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2017-02-07 |